A client asks the nurse why they have to go to therapy and cannot just take the prescribed antidepressant medication. Which would be the most therapeutic response by the nurse?

Choice A reason: Increased sleep may occur with sertraline due to its sedative effects, but it is not the priority assessment. Early in treatment, SSRIs can increase energy before mood improvement, heightening suicide risk, making suicidal ideation a more urgent concern.

Choice B reason: Sertraline, an SSRI, can initially increase energy in severe depression before fully improving mood, potentially increasing suicide risk. Assessing suicidal ideation is the priority to ensure safety, as this risk is highest early in treatment, requiring immediate intervention if present.

Choice C reason: Emotional changes are expected with sertraline as it improves mood over weeks. However, this is less urgent than assessing suicidal ideation, which poses an immediate safety risk, especially in severe depression during the early phase of SSRI treatment.

Choice D reason: Increased socialization may indicate improved depressive symptoms but is a secondary outcome. The priority is assessing suicidal ideation, as SSRIs can paradoxically increase suicide risk early in treatment due to improved energy without full mood stabilization, requiring vigilant monitoring.

Choice A reason: Buspirone is a non-benzodiazepine anxiolytic that takes weeks to achieve therapeutic effects, making it ineffective for acute panic attacks. It does not provide immediate relief, so administering it during a panic attack does not promote safety or address the client’s acute distress.

Choice B reason: Offering therapy during a panic attack may be overwhelming, as the client’s heightened anxiety impairs their ability to engage in therapeutic dialogue. Safety-focused interventions, like reducing stimuli or staying with the client, are more effective in managing acute panic and ensuring immediate safety.

Choice C reason: Turning off televisions or music reduces environmental stimuli, which can exacerbate a panic attack by overwhelming the client’s heightened sympathetic nervous system response. Minimizing sensory input helps de-escalate anxiety, creating a calmer environment and promoting safety during the acute episode.

Choice D reason: Remaining with the client during a panic attack provides reassurance and ensures safety by monitoring for escalating symptoms or self-harm risks. The nurse’s presence helps stabilize the client emotionally and physically, reducing feelings of isolation and supporting de-escalation of the panic state.

Choice E reason: A calm nursing approach prevents further escalation of the client’s panic by modeling stability and reducing perceived threats. A calm demeanor lowers the client’s sympathetic arousal, fostering a sense of safety and helping to de-escalate the acute anxiety episode effectively.